Microsoft word - osteochondritis_dissecans_sx.doc
Osteochondritis Dissecans (OCD)
Osteochondritis dissecans, commonly known as OCD, is a disease of the
cartilage that can affect various joints in a dog. In a dog with OCD, joint
cartilage is damaged or grows abnormally. Instead of being attached to the
bone it covers, it separates or cracks. A loose flap of cartilage may form, or an
entire piece may break loose. The damage to the cartilage leads to the
development of degeneration of the joint and osteoarthritis.
OCD is primarily a problem in large or giant breed dogs. It has been reported
in small dogs and cats, though it is not very common. It generally occurs when
the animal is between 4 and 10 months of age, though it can show up in older
OCD may affect the shoulder, elbow, knee or hock, although the elbow is
most commonly affected. The symptoms are lameness in the affected limb.
Some dogs have a barely noticeable limp and others are unable to bear any
weight on the leg. The lameness tends to worsen after periods of exercise
and improves after rest. When the condition has resulted in the early
development of joint arthritis, stiffness on rising is commonly seen.
Occasionally, the disease will affect both limbs simultaneously and the dog
may be reluctant to move.
Diagnosis is based on history, physical exam, and radiographs (x-rays). On
physical exam, we notice joint pain. As the disease progresses loss in the
joint’s range of motion will also become apparent. During the physical
examination flexion and extension of the shoulder joint may worsen the
Radiographs of the affected joint are taken to confirm the diagnosis. The dog
is often sedated or anaesthetised so that full relaxation of the joint can be
obtained. Several views of the affected joint and the healthy joint on the other
side are taken for comparison. A change of the bone underneath the
damaged cartilage is often visible. If the radiographs are not confirmatory but
OCD is still suspected, radiographs may be taken again in 2 to 3 weeks.
There are currently two ways to treat OCD, conservative medical treatment or surgical removal of the lesion. Conservative treatment may be indicated for dogs that have early or only mild symptoms of OCD. Conservative treatment consists of restricted activity for 4 to 6 weeks. Lead walking is permitted but no running or playing is allowed. Anti-inflammatories and painkillers such as carprofen (Rimadyl) or meloxicam (Metacam) may be indicated. In addition, the use of joint supplements such as glucosamine/chondroitin products is highly recommended. Conservative treatment may be difficult in young, active puppies who may still need to undergo surgery, if the symptoms do not improve.
Surgery is indicated in animals that show severe symptoms, in cases where large lesions are identified on radiographs or when conservative treatments fail. The surgery is very straightforward. The affected joint is opened and the offending flap, defect, or joint mouse is removed. The joint surface is inspected and cleaned before the approach is closed. The prognosis is generally good when the shoulder joint is affected but with other joints, degenerative joint disease (osteoarthritis) will be more likely to become a later issue.
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